A Workshop on Smoking Cessation for Pharmacy Students

Objective. To develop, implement, and evaluate a targeted educational intervention focusing on smoking cessation with final-year undergraduate pharmacy students.Design. A smoking-cessation educational workshop entitled Smoking Cessation in Pharmacy (SCIP) was designed on the principles of adult learning and implemented with a full cohort of final-year undergraduate pharmacy students at the University of Sydney. A previously validated questionnaire testing the knowledge and attitudes of respondents was administered both before and after implementation of the designed workshop to evaluate changes resulting from the intervention. Informal feedback was obtained from students.Assessment. Pre-course mean total knowledge and attitude scores calculated were 65.8±9.1 and 86.4±12.1, respectively. The post-course mean total knowledge score was 74.9±8.1, and the attitude score was 88.8±9.1 Improvement in knowledge and attitudes was significant (p<0.05).Conclusion. Educational interventions for pharmacy students designed with careful attention to pedagogic principles can improve knowledge about evidence-based smoking-cessation strategies and enhance positive attitudes to pharmacist roles in smoking cessation.     

A Team-Based Learning Course on Nutrition and Lifestyle Modification

Objective. To create, implement, and evaluate an elective team-based learning (TBL) course on nutrition and lifestyle modification for pharmacy students.Design. An elective course with 15 contact hours was developed for second-year pharmacy students based on the principles of TBL. Student knowledge gained and satisfaction with the course were measured.Assessment. Sixty-two students completed the course. Knowledge about nutrition and lifestyle modification was significantly improved by completing the course (59% and 91%, respectively, p=<0.001). The satisfaction survey instrument had a response rate of 97%, and the majority of students (>85%) responded favorably to the TBL components.Conclusion. An elective course using TBL effectively delivered course content while teaching students communication and teamwork skills. The course was well received by students.     

Using Grey Literature to Prepare Pharmacy Students for an Evolving Healthcare Delivery System

Objectives. To assess the impact of using “grey literature” (information internally produced in print or electronic format by agencies such as hospitals, government, businesses, etc) rather than a textbook in a course on healthcare delivery systems on students’ perception of the relevance of healthcare delivery system topics and their ability to identify credible sources of this information.Design. A reading from the grey literature was identified and assigned to the students for each topic in the course.Assessment. Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments. Students’ knowledge of current and credible sources of information on healthcare delivery system topics significantly improved based on self-reports and scores on objective assessments (p<0.05).Conclusions. Assignment of grey literature in a course on healthcare delivery systems can be used to ensure that information in the pharmacy school curriculum is the most current and credible information available.     

Effectiveness of a national approach to prescribing education for multiple disciplines

Aims

To evaluate the effectiveness of a national approach to prescribing education on health professional students’ prescribing and therapeutics knowledge, across multiple disciplines.

Methods

In a university examination setting, 83 medical, 40 pharmacy and 13 nurse practitioner students from three different universities completed a set of multiple choice questions (MCQs) before and after completing an online module from the National Prescribing Curriculum (NPC). To minimize overestimation of knowledge, students had to indicate the level of certainty for each answer on a three‐point scale. MCQs were scored using a validated certainty‐based marking scheme resulting in a composite score (maximum 30 and minimum −60). Students were asked to rate their perception of usefulness of the module.

Results

At the pre‐module phase, there were no significant differences in the composite MCQ scores between the medical (9.0 ± 10.3), pharmacy (10.2 ± 10.6) and nurse practitioner (8.0 ± 10.7) students. The scores improved significantly for all groups at the post‐module phase (P < 0.01 for all groups) by similar extents (post‐module results: medical, 14.5 ± 9.6; pharmacy, 14.4 ± 9.9; nurse practitioner, 12.1 ± 9.6). 39.4% of the MCQs answered incorrectly with high level of certainty at the pre‐module phase were still answered incorrectly with high level of certainty at the post‐module phase. Almost all students (with no significant difference between the groups) found the NPC modules, post‐module MCQs and feedback useful as a learning tool.

Conclusions

A national online approach to prescribing education can improve therapeutics knowledge of students from multiple disciplines of health care and contribute towards streamlining interdisciplinary learning in medication management.     

A Standardized Patient Counseling Rubric for a Pharmaceutical Care and Communications Course

Objective. To restructure a required pharmaceutical care and communications course to place greater emphasis on communication skills and include a high-stakes assessment.Design. A standardized counseling rubric was developed for use throughout the pharmacy curriculum and the counseling laboratory practicals were changed to high-stakes assessments.Assessment. An annual mid-semester and end-of-semester high-stakes patient-counseling objective structured clinical examination (OSCE) conducted prior to and after revision of the course and counseling rubric documented improvements in students’ scores. Performance on the post-course annual assessment patient counseling OSCE improved compared to that on the pre-course (p<0.001).Conclusion. The 2010 course revision improved students’ medication counseling abilities and readiness to practice. Major course revisions should be undertaken only after input from all stakeholders and with data to support the need for change.     

Self-Efficacy and Self-Esteem in Third-Year Pharmacy Students

Objective. To identify the experiential and demographic factors affecting the self-efficacy and self-esteem of third-year pharmacy (P3) students.Methods. A 25-item survey that included the Rosenberg Self-Esteem Scale and the General Self-Efficacy Scale, as well as types and length of pharmacy practice experiences and demographic information was administered to doctor of pharmacy (PharmD) students from 5 schools of pharmacy in New England at the completion of their P3 year.Results. The survey response rate was approximately 50% of the total target population (399/820). Students with a grade point average (GPA)≥3.0 demonstrated a higher significant effect from unpaid introductory pharmacy practice experiences (IPPEs) on their self-efficacy scores (p<0.05) compared to students with lower GPAs. Students who had completed more than the required amount of pharmacy experiences had higher levels of self-efficacy and self-esteem (p<0.05). Ethnicity also was related to students’ levels of self-efficacy and self-esteem.Conclusion. Self-efficacy and self-esteem are two important factors in pharmacy practice. Colleges and schools of pharmacy should ensure that students complete enough practice experiences, beyond the minimum of 300 IPPE hours, as one way to improve their self-efficacy and self-esteem.     

Effects of Remote Proctoring on Composite Examination Performance Among Doctor of Pharmacy Students

Objective. To determine the impact of remote proctoring on the academic performance of Doctor of Pharmacy (PharmD) students.Methods. This was a retrospective, observational study that compared first professional year (P1) and second professional year (P2) pharmacy students’ scores on eight composite examinations administered in spring 2020 (n = 387), the final three of which were proctored remotely, to that of a historical cohort of pharmacy students who took the same examinations in spring 2019 (n = 368). To assess whether remote proctoring affected academic performance, spring 2020 scores for examinations 6, 7, and 8 were compared to those of a historical cohort who took the same examinations in person with a proctor present in spring 2019. Academic performance on examinations 1 through 4 was also compared between the two cohorts to evaluate any possible year-to-year variation in academic performance during non-remote circumstances. Mann Whitney tests were used to compare scores between the two cohorts.Results. The median scores of students in the spring 2020 cohort were significantly lower than the scores of the historical cohort on the first composite examination administered to P1 students after the implementation of remote proctoring. In contrast, median scores were significantly higher on two of the three examinations administered to P2 students using remote proctoring.Conclusion. Remote proctoring has minimal impact on pharmacy students’ examination performance and its use should be considered to ensure academic honesty and security of testing content in a distance learning environment.     

Critical Thinking and Reflection Exercises in a Biochemistry Course to Improve Prospective Health Professions Students’ Attitudes Toward Physician-Pharmacist Collaboration

Objective. To determine the impact of performing critical-thinking and reflection assignments within interdisciplinary learning teams in a biochemistry course on pharmacy students’ and prospective health professions students’ collaboration scores.Design. Pharmacy students and prospective medical, dental, and other health professions students enrolled in a sequence of 2 required biochemistry courses. They were randomly assigned to interdisciplinary learning teams in which they were required to complete case assignments, thinking and reflection exercises, and a team service-learning project.Assessment. Students were asked to complete the Scale of Attitudes Toward Physician-Pharmacist Collaboration prior to the first course, following the first course, and following the second course. The physician-pharmacist collaboration scores of prospective health professions students increased significantly (p<0.001).Conclusions. Having prospective health professions students work in teams with pharmacy students to think and reflect in and outside the classroom improves their attitudes toward physician-pharmacist collaboration.     

Home Medication Reviews in a Patient Care Experience for Undergraduate Pharmacy Students

Objectives. To evaluate the effectiveness of conducting medication management reviews (MMRs) and home medication reviews (HMRs) on improving undergraduate pharmacy students'' pharmaceutical care skills and clinical knowledge.Design. Fifth-year bachelor of science in pharmacy students were enrolled in a structured course in which MMR cases based on real patient scenarios were completed, findings were discussed in groups, and comprehensive feedback was provided by course instructors. Each student was then asked to recruit a real patient through a community pharmacy and conduct an HMR.Assessment. Students’ pre- and post-course scores on the same MMR case improved significantly, with 84.6% of students passing the post-course assessment. Students also completed a new post-course MMR case and 74.8% received a passing score. Students'' answers on a post-course self-assessment showed a significant improvement in their scores regarding knowledge and skills in conducting MMRs and HMRs.Conclusion. Medication management reviews and home medication reviews are excellent tools for educating pharmacy students and providing them with needed actual clinical practice experience.     

The Impact of Advanced Pharmacy Practice Experiences on Students' Readiness for Self-directed Learning

Objective

To evaluate the impact of advanced pharmacy practice experiences (APPEs) on doctor of pharmacy (PharmD) students'' readiness for self-directed learning.

Methods

The Self-Directed Learning Readiness Scale (SDLRS) was administered to students prior to and after completing their APPEs. SDLRS is a validated instrument that determines the relative degree to which students have the attitudes and motivation to engage in self-directed learning.

Results

Seventy-seven (64%) students completed the SDLRS prior to starting their APPEs and 80 (67%) students completed the instrument after completing their APPEs. Forty-six (38%) students completed both. Prior to starting their APPEs, 74% of students scored greater than 150 on the SDLRS, indicating a high level of readiness for self-directed learning. No significant difference was found between the mean scores of students who took the SDLRS both prior to (159 ± 20) and after completing their APPEs (159 ± 24; p > 0.05).

Conclusion

Students at our institution appear to be ready for self-directed learning but APPEs had a minimal impact on their readiness for self-directed learning.     

Implementation of an Accelerated Physical Examination Course in a Doctor of Pharmacy Program

Objective. To describe the implementation of a 1-day accelerated physical examination course for a doctor of pharmacy program and to evaluate pharmacy students’ knowledge, attitudes, and confidence in performing physical examination.Design. Using a flipped teaching approach, course coordinators collaborated with a physician faculty member to design and develop the objectives of the course. Knowledge, attitude, and confidence survey questions were administered before and after the practical laboratory.Assessment. Following the practical laboratory, knowledge improved by 8.3% (p<0.0001). Students’ perceived ability and confidence to perform a physical examination significantly improved (p<0.0001). A majority of students responded that reviewing the training video (81.3%) and reading material (67.4%) prior to the practical laboratory was helpful in learning the physical examination.Conclusion. An accelerated physical examination course using a flipped teaching approach was successful in improving students’ knowledge of, attitudes about, and confidence in using physical examination skills in pharmacy practice.     

A Service-Learning Course for First-Year Pharmacy Students

Objectives

To describe the design of a required service-learning course offered to first- year (P1) pharmacy students, and to assess student learning and the relevance of this learning in the pharmacy curriculum.

Design

A 14-week service-learning course was designed and community organizations were recruited to participate. All first-year students enrolled in the School completed the course. A post-course survey was administered to the students, inquiring about what they had learned from the course; supervisors at the students'' service sites also completed a short survey.

Assessment

The course and the student survey instrument were completed by 195 students, and of these 190 gave permission for the information they provided to be used in the study. Notable learning outcomes were identified, especially in the areas of communication and the social and behavioral aspects of pharmacy.

Conclusion

The survey administered at the conclusion of the course described in this article demonstrated that students in the course had achieved the desired learning outcomes. This shows that service-learning is a pedagogy that educators can employ to effect relevant learning in the pharmacy curriculum.     

A Comparison of Pharmacy Students’ and Active Older Adults' Perceptions Regarding Geriatric Quality of Life

Objectives. To measure perceptions of quality of life (QOL) in an active geriatric population and compare their responses with pharmacy students’ perceptions of older adult QOL.Methods. Pharmacy students and active older adults completed the modified and standard version of a validated health survey instrument, respectively, and their responses were compared.Results. Eighty-six students and 20 active older adults participated. Student perceptions of geriatric QOL were significantly lower in all domains except health change compared to older adult perceptions (p<0.001 for all domains). Interest in a geriatric pharmacy career (p=0.04) and previously having taken the Perspectives in Geriatrics course and laboratory (p=0.05 and 0.02, respectively) were significantly associated with higher student scores on the physical component portion of the survey.Conclusion. Stronger emphasis on geriatric QOL within pharmacy curricula may improve pharmacy students’ perceptions regarding outcomes related to healthy older adults.     

Physical assessment experience in a problem-based learning course

Objective. To evaluate the impact of a physical-assessment learning experience implemented in the problem-based learning (PBL) format of the third year of a doctor of pharmacy (PharmD) program.Design. Students enrolled in a PBL course completed survey instruments to measure knowledge and confidence before and after participating in the learning experience. A simulation stethoscope was used to teach students abnormal pulmonary and cardiovascular sounds in 1-hour sessions for each of 12 PBL groups.Assessment. The 92 students enrolled in the PBL course completed pre- and post-experience survey instruments. Students’ scores on knowledge questions increased significantly (p < 0.0001) from 40.4% ± 11.4% at baseline to 62.5% ± 13.7% and 63.1 ± 11.6%, respectively, on the 2 sets of post-experience questions. Students scored a median of 3 or 4 on a 5-point Likert scale after a learning experience on questions measuring confidence.Conclusion. Use of a simulation stethoscope in a physical-assessment learning experience increased pharmacy students’ knowledge in performing pulmonary and cardiovascular assessment techniques.     

Online Virtual-Patient Cases Versus Traditional Problem-Based Learning in Advanced Pharmacy Practice Experiences

Objective. To evaluate the efficacy of faculty-led problem-based learning (PBL) vs online simulated-patient case in fourth-year (P4) pharmacy students.Design. Fourth-year pharmacy students were randomly assigned to participate in either online branched-case learning using a virtual simulation platform or a small-group discussion. Preexperience and postexperience student assessments and a survey instrument were completed.Evaluation. While there were no significant differences in the preexperience test scores between the groups, there was a significant increase in scores in both the virtual-patient group and the PBL group between the preexperience and postexperience tests. The PBL group had higher postexperience test scores (74.8±11.7) than did the virtual-patient group (66.5±13.6) (p=0.001).Conclusion. The PBL method demonstrated significantly greater improvement in postexperience test scores than did the virtual-patient method. Both were successful learning methods, suggesting that a diverse approach to simulated patient cases may reach more student learning styles.     

Widespread myocardial dysfunction in COVID-19 patients detected by myocardial strain imaging using 2-D speckle-tracking echocardiography

COVID-19 is a multiorgan systemic inflammatory disease caused by SARS-CoV-2 virus. Patients with COVID-19 often exhibit cardiac dysfunction and myocardial injury, but imaging evidence is lacking. In the study we detected and evaluated the severity of myocardial dysfunction in COVID-19 patient population using two-dimensional speckle-tracking echocardiography (2-D STE). A total of 218 consecutive patients with confirmed diagnosis of COVID-19 who had no underlying cardiovascular diseases were enrolled and underwent transthoracic echocardiography. This study cohort included 52 (23.8%) critically ill and 166 noncritically ill patients. Global longitudinal strains (GLSs) and layer-specific longitudinal strains (LSLSs) were obtained using 2-D STE. Changes in GLS were correlated with the clinical parameters. We showed that GLS was reduced (<−21.0%) in about 83% of the patients. GLS reduction was more common in critically sick patients (98% vs. 78.3%, P < 0.001), and the mean GLS was significantly lower in the critically sick patients than those noncritical (−13.7% ± 3.4% vs. −17.4% ± 3.2%, P < 0.001). The alteration of GLS was more prominent in the subepicardium than in the subendocardium (P < 0.001). GLS was correlated to mean serum pulse oxygen saturation (SpO₂, RR = 0.42, P < 0.0001), high-sensitive C-reactive protein (hsCRP, R = −0.20, P = 0.006) and inflammatory cytokines, particularly IL-6 (R = −0.21, P = 0.003). In conclusions, our results demonstrate that myocardial dysfunction is common in COVID-19 patients, particularly those who are critically sick. Changes in indices of myocardial strain were associated with indices of inflammatory markers and hypoxia, suggesting partly secondary nature of myocardial dysfunction.     

An elective course to promote academic pharmacy as a career

Objective. To implement and assess an elective course that engages pharmacy students’ interest in and directs them toward a career in academia.Design. A blended-design elective that included online and face-to-face components was offered to first through third-year pharmacy studentsAssessment. Students’ knowledge, skills, and attitudes toward academic pharmacy were measured by pre- and post-course assessments, online quizzes, personal journal entries, course assignments, and exit interviews. The elective course promoting academic pharmacy as a profession was successful and provided students with an awareness about another career avenue to consider upon graduation. The students demonstrated mastery of the course content.Conclusions. Students agreed that the elective course on pharmacy teaching and learning was valuable and that they would recommend it to their peers. Forty percent responded that after completing the course, they were considering academic pharmacy as a career.     

Impact of online lecture-capture on student outcomes in a therapeutics course

Objectives

To examine the correlation between students accessing recorded lecture files (audio and slides) online and course grades and class attendance.

Methods

Second professional year (of 6-year program) students in a therapeutics course had access to recorded online lectures for 72 hours following live lectures. The number and duration of lecture accessions were compared to final course grades and class attendance. Course grades were compared to those of a historical control group. At the end of the semester, students completed a brief survey instrument regarding their use and perceptions of online lectures.

Results

No correlation was found between final course grades and the number of lecture accessions (r = 0.0014) or total number of minutes lectures were viewed (r = 0.033), nor between class attendance and minutes viewed (r = 0.2158). Students with access to recorded lectures outperformed the historical control group on the final examination (p < 0.002). Seventy-two percent of students reported no influence of online files on class attendance.

Conclusions

Posting lectures online did not affect student outcomes, but students did score higher on the final examination.     

Virtual Coaching Delivered by Pharmacists to Prevent COVID-19 Transmission

Background: While the role of pharmacists in the current pandemic control has been recognized worldwide, their coaching efforts to improve public’s behaviors that could prevent COVID-19 transmission has been rarely investigated. Objectives: To assess whether pharmacist-based virtual health coaching sessions could increase the proportion of people who practised healthy social behaviors, to test whether this model can increase the public acceptance of COVID-19 vaccines, and to measure whether these behaviors could actually prevent contracting COVID-19. Method: In this randomized controlled trial, adults who matched specific criteria were randomly allocated into 2 arms. The active arm received 12 pharmacist-based virtual coaching sessions delivered via Zoom^® over a month. Participants allocated to the control arm received no coaching. At the end of the last coaching session, both groups were asked to complete a structured questionnaire for outcome assessment. Participants in the active group were followed up to 2 weeks after the end of the last coaching session to check if they contracted COVID-19 or not. The SPSS software version 26.0 (IBM Corp., Chicago, IL) was used for statistical analysis. Results: Of the 300 participants who gave consent for participation, 295 completed the study (147 from the active arm and 148 from the control arm). The proportion of those using face masks, avoiding crowds, and willing to be isolated if infected in the active arm was increased from 51.70%, 53.74%, and 59.86% at baseline to 91.83%, 80.27%, and 96.59% at the end of coaching, respectively (all with P < .05). In addition, the proportion of behaviors, such as disinfecting surfaces, not touching the T-zone, and avoid sharing personal belongings with colleagues at work was increased from 36.05%, 27.89%, and 46.93% at baseline to 63.94%, 52.38%, and 87.75% at the end of coaching, respectively (all with P < .05). Avoid touching the T-zone (OR = 0.43; 95% CI, 0.24-0.89) and using disposable tissues (OR = 0.30; 95% CI, 0.18-0.77), each versus using face masks appropriately were more likely to get COVID-19. Conclusion: Pharmacist-based virtual health coaching could be a potential strategy to increase the proportion of behaviors that could curtail the spread of COVID-19.